Author: The National Academies Press

Final Book Now Available

Changes in the 21st century security environment require new analytic approaches to support strategic deterrence. Because current adversaries may be deterred from the use of nuclear weapons differently than were Cold War adversaries, the Air Force needs an analytic process and tools that can help determine those Air Force capabilities that will successfully deter or defeat these new nuclear-armed adversaries and assure U.S. allies. While some analytic tools are available, a coherent approach for their use in developing strategy and policy appears to be lacking. Without a coherent analytic approach that addresses the nuances of today’s security environment, Air Force views of its strategic deterrence needs may not be understood or accepted by the appropriate decision makers.

A coherent approach will support Air Force decisions about its strategic force priorities and needs, deter actual or potential adversaries, and assure U.S. allies. In this context, the Air Force in 2012 requested that the Air Force Studies Board of the National Research Council undertake a workshop to bring together national experts to discuss current challenges relating strategic deterrence and potential new tools and methods that the Air Force might leverage in its strategic deterrence mission.

The workshop consisted of two 3-day sessions held in Washington, DC on September 26-28, 2012 and January 29-31, 2013 and was attended by a very diverse set of participants with expertise in strategic deterrence and a range of analytic tools of potential interest to the Air Force. U.S. Air Force Strategic Deterrence Capabilities in the 21st Century Security Environment summarizes this workshop.

[Read the full report]

Topics: Conflict and Security Issues

Final Book Now Available

Over the course of several decades, copyright protection has been expanded and extended through legislative changes occasioned by national and international developments. The content and technology industries affected by copyright and its exceptions, and in some cases balancing the two, have become increasingly important as sources of economic growth, relatively high-paying jobs, and exports. Since the expansion of digital technology in the mid-1990s, they have undergone a technological revolution that has disrupted long-established modes of creating, distributing, and using works ranging from literature and news to film and music to scientific publications and computer software.

In the United States and internationally, these disruptive changes have given rise to a strident debate over copyright’s proper scope and terms and means of its enforcement–a debate between those who believe the digital revolution is progressively undermining the copyright protection essential to encourage the funding, creation, and distribution of new works and those who believe that enhancements to copyright are inhibiting technological innovation and free expression.

Copyright in the Digital Era: Building Evidence for Policy examines a range of questions regarding copyright policy by using a variety of methods, such as case studies, international and sectoral comparisons, and experiments and surveys. This report is especially critical in light of digital age developments that may, for example, change the incentive calculus for various actors in the copyright system, impact the costs of voluntary copyright transactions, pose new enforcement challenges, and change the optimal balance between copyright protection and exceptions.

[Read the full report]

Topics: Engineering and Technology | Computers and Information Technology

Final Book Now Available

Extremely hazardous substances (EHSs) can be released accidentally as a result of result of chemical spills, industrial explosions, fires, or accidents involving railroad cars and trucks transporting EHSs. Workers and residents in communities surrounding industrial facilities where EHSs are manufactured, used, or stored and in communities along the nation’s railways and highways are potentially at risk of being exposed to airborne EHSs during accidental releases or intentional releases by terrorists. Pursuant to the Superfund Amendments and Reauthorization Act of 1986, the U.S. Environmental Protection Agency (EPA) has identified approximately 400 EHSs on the basis of acute lethality data in rodents.

As part of its efforts to develop acute exposure guideline levels for EHSs, EPA and the Agency for Toxic Substances and Disease Registry (ATSDR) in 1991 requested that the National Research Council (NRC) develop guidelines for establishing such levels. In response to that request, the NRC published Guidelines for Developing Community Emergency Exposure Levels for Hazardous Substances in 1993. Subsequently, Standard Operating Procedures for Developing Acute Exposure Guideline Levels for Hazardous Substances was published in 2001, providing updated procedures, methodologies, and other guidelines used by the National Advisory Committee (NAC) on Acute Exposure Guideline Levels for Hazardous Substances and the Committee on Acute Exposure Guideline Levels (AEGLs) in developing the AEGL values.

Using the 1993 and 2001 NRC guidelines reports, the NAC—consisting of members from EPA, the Department of Defense (DOD), the Department of Energy (DOE), the Department of Transportation (DOT), other federal and state governments, the chemical industry, academia, and other organizations from the private sector—has developed AEGLs for more than 270 EHSs. In 1998, EPA and DOD requested that the NRC independently review the AEGLs developed by NAC. In response to that request, the NRC organized within its Committee on Toxicology (COT) the Committee on Acute Exposure Guideline Levels, which prepared this report. This report is the fourteenth volume in that series. Acute Exposure Guideline Levels for Selected Airborne Chemicals: Volume 14 summarizes the committee’s conclusions and recommendations.

[Read the full report]

Topics: Environment and Environmental Studies

Prepublication Now Available

The US Fish and Wildlife Service (FWS) and the National Marine Fisheries Service (NMFS) are responsible for protecting species that are listed as endangered or threatened under the Endangered Species Act (ESA) and for protecting habitats that are critical for their survival. The US Environmental Protection Agency (EPA) is responsible for registering or reregistering pesticides under the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) and must ensure that pesticide use does not cause any unreasonable adverse effects on the environment, which is interpreted to include listed species and their critical habitats. The agencies have developed their own approaches to evaluating environmental risk, and their approaches differ because their legal mandates, responsibilities, institutional cultures, and expertise differ. Over the years, the agencies have tried to resolve their differences but have been unsuccessful in reaching a consensus regarding their assessment approaches.

As a result, FWS, NMFS, EPA, and the US Department of Agriculture asked the National Research Council (NRC) to examine scientific and technical issues related to determining risks posed to listed species by pesticides. Specifically, the NRC was asked to evaluate methods for identifying the best scientific data available; to evaluate approaches for developing modeling assumptions; to identify authoritative geospatial information that might be used in risk assessments; to review approaches for characterizing sublethal, indirect, and cumulative effects; to assess the scientific information available for estimating effects of mixtures and inert ingredients; and to consider the use of uncertainty factors to account for gaps in data. Assessing Risks to Endangered and Threatened Species from Pesticides, which was prepared by the NRC Committee on Ecological Risk Assessment under FIFRA and ESA, is the response to that request.

[Read the full report]

Topics: Environment and Environmental Studies

Prepublication Now Available

The National Nanotechnology Initiative (NNI) is a multiagency, multidisciplinary federal initiative comprising a collection of research programs and other activities funded by the participating agencies and linked by the vision of “a future in which the ability to understand and control matter at the nanoscale leads to a revolution in technology and industry that benefits society.” As first stated in the 2004 NNI strategic plan, the participating agencies intend to make progress in realizing that vision by working toward four goals. Planning, coordination, and management of the NNI are carried out by the interagency Nanoscale Science, Engineering, and Technology (NSET) Subcommittee of the National Science and Technology Council (NSTC) Committee on Technology (CoT) with support from the National Nanotechnology Coordination Office (NNCO).

Triennial Review of the National Nanotechnology Initiative is the latest National Research Council review of the NNI, an assessment called for by the 21st Century Nanotechnology Research and Development Act of 2003. The overall objective of the review is to make recommendations to the NSET Subcommittee and the NNCO that will improve the NNI’s value for basic and applied research and for development of applications in nanotechnology that will provide economic, societal, and national security benefits to the United States. In its assessment, the committee found it important to understand in some detail—and to describe in its report—the NNI’s structure and organization; how the NNI fits within the larger federal research enterprise, as well as how it can and should be organized for management purposes; and the initiative’s various stakeholders and their roles with respect to research. Because technology transfer, one of the four NNI goals, is dependent on management and coordination, the committee chose to address the topic of technology transfer last, following its discussion of definitions of success and metrics for assessing progress toward achieving the four goals and management and coordination. Addressing its tasks in this order would, the committee hoped, better reflect the logic of its approach to review of the NNI. Triennial Review of the National Nanotechnology Initiative also provides concluding remarks in the last chapter.

[Read the full report]

Topics: Engineering and Technology

Final Book Now Available

Increasing renewable energy development, both within the United States and abroad, has rekindled interest in the potential for marine and hydrokinetic (MHK) resources to contribute to electricity generation. These resources derive from ocean tides, waves, and currents; temperature gradients in the ocean; and free-flowing rivers and streams. One measure of the interest in the possible use of these resources for electricity generation is the increasing number of permits that have been filed with the Federal Energy Regulatory Commission (FERC). As of December 2012, FERC had issued 4 licenses and 84 preliminary permits, up from virtually zero a decade ago. However, most of these permits are for developments along the Mississippi River, and the actual benefit realized from all MHK resources is extremely small. The first U.S. commercial gridconnected project, a tidal project in Maine with a capacity of less than 1 megawatt (MW), is currently delivering a fraction of that power to the grid and is due to be fully installed in 2013.

As part of its assessment of MHK resources, DOE asked the National Research Council (NRC) to provide detailed evaluations. In response, the NRC formed the Committee on Marine Hydrokinetic Energy Technology Assessment. As directed in its statement of task (SOT), the committee first developed an interim report, released in June 2011, which focused on the wave and tidal resource assessments (Appendix B). The current report contains the committee’s evaluation of all five of the DOE resource categories as well as the committee’s comments on the overall MHK resource assessment process. This summary focuses on the committee’s overarching findings and conclusions regarding a conceptual framework for developing the resource assessments, the aggregation of results into a single number, and the consistency across and coordination between the individual resource assessments. Critiques of the individual resource assessment, further discussion of the practical MHK resource base, and overarching conclusions and recommendations are explained in An Evaluation of the U.S. Department of Energy’s Marine and Hydrokinetic Resource Assessment.

[Read the full report]

Topics: Energy and Energy Conservation | Earth Sciences

Prepublication Now Available

The Institute of Medicine (IOM) and the National Research Council (NRC) have had prominent roles in discussions of aging, disability, and technology for decades. In 1978, Aging and Medical Education (IOM, 1978) raised national awareness of the challenges to physicians posed by the aging of the U.S. population. Thirty years later, Retooling for an Aging America highlighted concerns for the entire health care workforce in view of the aging of the population, including the role of technology in caring for older populations. The 1988 report The Aging Population in the 21st Century examined social, economic, and demographic changes among older adults, as well as many health-related topics: health promotion and disease prevention; quality of life; health care system financing and use; and the quality of care— especially long-term care. In 1991, the landmark report Disability in America laid out a national agenda to prevent disability and improve the lives of people with disabling conditions. The 1997 report Enabling America: Assessing the Role of Rehabilitation Science and Engineering examined the knowledge base of rehabilitation science and engineering and proposed ways to translate scientific findings into interventions that produce better health. And the 2007 report The Future of Disability in America examined progress made since the earlier reports and looked at continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities.

All these reports were produced by committees appointed in accordance with guidelines of the National Academies and met multiples times to compile and review evidence, reach consensus on conclusions and recommendations, draft a report of the committee, and then modify that draft report in response to comments from outside reviewers. The IOM and NRC have also held several workshops related to aging, disability, and technology and published summary reports, such as Technology for Adaptive Aging and Grand Challenges of Our Aging Society. The IOM and NRC also convene groups that take a different approach to issues of pressing national and international importance. Often known as forums or roundtables, these groups meet regularly to foster dialogue and confront issues of mutual interest and concern among a broad range of stakeholders. They can convene workshops, initiate cooperative projects among members, commission independently authored articles, and generate ideas for independent consensus studies.

In 2012 the IOM and NRC joined together to establish the Forum on Aging, Disability, and Independence to provide a neutral venue for broad-ranging discussions among the many stakeholders involved with aging and disability. The goals of the forum are to highlight areas in which the coordination of the aging and disability networks is strong, examine the challenges involved in aligning the aging and disability networks, explore new approaches for resolving problem areas, elevate the visibility and broaden the perspectives of stakeholders, and set the stage for future policy actions. Forum sponsors and members include federal agencies, health professional associations, private sector businesses, academics, and consumers. Fostering Independence, Participation, and Healthy Aging Through Technology summarizes this workshop.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

Tobacco use is the leading cause of preventable death in United States, causing more than 440,000 deaths annually and resulting in $193 billion in health-related economic losses each year–$96 billion in direct medical costs and $97 billion in lost productivity. Since the first U.S. Surgeon General’s report on smoking in 1964, more than 29 Surgeon General’s reports, drawing on data from thousands of studies, have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. This evidence base links tobacco use to the development of multiple types of cancer and other life-threatening conditions, including cardiovascular and respiratory diseases. Smoking accounts for at least 30 percent of all cancer deaths, and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing tobacco use prevalence from over 40 percent at the time of the 1964 Surgeon General’s report to less than 20 percent today, recent progress in reducing tobacco use has slowed. An estimated 18.9 percent of U.S. adults smoke cigarettes, nearly one in four high school seniors smoke, and 13 percent of high school males use smokeless tobacco products.

In recognition that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened a public workshop, Reducing Tobacco-Related Cancer Incidence and Mortality, June 11-12, 2012 in Washington, DC. In opening remarks to the workshop participants, planning committee chair Roy Herbst, professor of medicine and of pharmacology and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, described the goals of the workshop, which were to examine the current obstacles to tobacco control and to discuss potential policy, outreach, and treatment strategies that could overcome these obstacles and reduce tobacco-related cancer incidence and mortality. Experts explored a number of topics, including: the changing demographics of tobacco users and the changing patterns of tobacco product use; the influence of tobacco use on cancer incidence and cancer treatment outcomes; tobacco dependence and cessation programs; federal and state level laws and regulations to curtail tobacco use; tobacco control education, messaging, and advocacy; financial and legal challenges to tobacco control efforts; and research and infrastructure needs to support tobacco control strategies, reduce tobacco related cancer incidence, and improve cancer patient outcomes. Reducing Tobacco-Related Cancer Incidence and Mortality summarizes the workshop.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

As mandated by the Global Change Research Act (GCRA), the U.S. Global Change Research Program is currently producing a “National Climate Assessment” (NCA). The NCA is a report to inform the President, the Congress, and the American people about the current state of scientific knowledge regarding climate change effects on U.S. regions and key sectors, now and in the coming decades. This document contains an evaluation of the draft NCA report, presented through consensus responses to the Panel’s Task Statement questions, and through a large collection of individual Panel member comments and suggestions for specific chapters, statements, figures, etc. While focusing primarily on practical suggestions for immediately improving the current draft, the Panel also raises some broader considerations about fundamental approaches used in certain parts of the NCA report, and about the scope of USGCRP research that underlies the NCA findings. Some suggestions can be viewed as longer-term advice for future versions of NCA work.

This NCA has been a significantly more ambitious effort than previous assessments, in terms of the scope of topics addressed and the breadth of public engagement processes involved. Some of the important new areas include the use of “traceable accounts,” the articulation of needs for future research and a vision for an ongoing assessment process, the outreach efforts to help various stakeholders define their climate-related information needs, and the initial (though incomplete) effort to assess the current state of climate change response activities around the nation. Given the current state of the science and the scope of resources available, we believe the NCA did a reasonable job of fulfilling its charge overall. Although more needs to be done to fully meet the nation’s needs for information and guidance, such needs cannot be met without an expanded research effort on the part of the USGCRP and future assessments.

The Panel suggests that the NCA report would be improved by addressing the numerous specific problems and concerns and the more cross-cutting issues raised in the consensus answers to the Task Statement questions—which include, for instance, the need to:

1. provide a clear overarching framework for the report that helps readers understand climate change as part of a complex system with interacting physical, biological, and human social/economic dimensions, and offers practical guidance on using iterative risk management strategies to make decisions in the face of large uncertainties;
2. clearly acknowledge how climate change affects and is affected by other types of major global environmental changes and other societal developments;
3. offer an explicit discussion about the uncertainties associated with the regional model projections presented in the NCA draft;
4. take full advantage of the e-book format planned for this document through strategic use of hyperlinks among different parts of the report and other innovative approaches that help guide the experience of the NCA’s diverse audiences.

As the nation continues to engage with the threats, opportunities, and surprises of climate change in its many manifestations, the 2013 NCA should prove to be a valuable resource, as a summary of the state of knowledge about climate change and its implications for the American people.

[Read the full report]

Topics: Earth Sciences | Behavioral and Social Sciences | Environment and Environmental Studies

Final Book Now Available

The United States holds a large amount of untapped wind energy, both land-based and offshore. The strongest and most consistent winds are either offshore or in rural areas, far from population centers that could benefit from the electricity produced. As of December 31, 2012, the United States had more than 60,000 megawatts of installed wind capacity—second only to China—all of it from land-based wind farms. Offshore wind development would supply energy to nearby population centers, especially on the East Coast. Yet the United States has no offshore turbines installed; many European nations have developed dozens of offshore wind farms over the past 15 years.

Congress passed the Energy Policy Act of 2005, which authorized the Secretary of the U.S. Department of the Interior (USDOI) to regulate renewable energy sources on the outer continental shelf (OCS). Initially, the Minerals Management Service (MMS) had responsibility for essential regulations and for implementing this new authority, in addition to regulating oil and gas development. In April 2010, MMS was reorganized (see Chapter 3), and previously coexisting functions were separated: resource development and energy management are now administered by the Bureau of Ocean Energy Management (BOEM), and health, safety, and environmental enforcement for offshore oil and gas is now administered by the Bureau of Safety and Environmental Enforcement (BSEE). The regulation of renewable energy is an exception to this organizational structure. USDOI issued its final regulations in 30 CFR 585, which gave BOEM authority to regulate all renewable energy development activities on the OCS. The agency still needed to provide guidance in many areas of offshore wind development, including ensuring the health and safety of offshore wind workers.

In August 2011, USDOI requested that the Marine Board of the National Research Council assess its approach for regulating the health and safety of wind farm workers on the OCS. Worker Health and Safety on Offshore Wind Farms reviews the following statements of task:

– Identify unique risks to worker health and safety on wind farms, as compared with oil and gas operations on the OCS;

– Identify any gaps or overlaps in jurisdictional authority; and

– Evaluate the adequacy of existing regulations and recommend enhancements to
regulations for worker health and safety on OCS wind farms.

[Read the full report]

Topics:

Final Book Now Available

When, in late 2011, it became public knowledge that two research groups had submitted for publication manuscripts that reported on their work on mammalian transmissibility of a lethal H5N1 avian influenza strain, the information caused an international debate about the appropriateness and communication of the researchers’ work, the risks associated with the work, partial or complete censorship of scientific publications, and dual-use research of concern in general.

Recognizing that the H5N1 research is only the most recent scientific activity subject to widespread attention due to safety and security concerns, on May 1, 2012, the National Research Council’s Committee on Science, Technology and Law, in conjunction with the Board on Life Sciences and the Institute of Medicine’s Forum on Microbial Threats, convened a one-day public workshop for the purposes of 1) discussing the H5N1 controversy; 2) considering responses by the National Institute of Allergy and Infectious Diseases (NIAID), which had funded this research, the World Health Organization, the U.S. National Science Advisory Board for Biosecurity (NSABB), scientific publishers, and members of the international research community; and 3) providing a forum wherein the concerns and interests of the broader community of stakeholders, including policy makers, biosafety and biosecurity experts, non-governmental organizations, international organizations, and the general public might be articulated.

Perspectives on Research with H5N1 Avian Influenza: Scientific Enquiry, Communication, Controversy summarizes the proceedings of the workshop.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

The original charter of the Space Science Board was established in June 1958, 3 months before the National Aeronautics and Space Administration (NASA) opened its doors. The Space Science Board and its successor, the Space Studies Board (SSB), have provided expert external and independent scientific and programmatic advice to NASA on a continuous basis from NASA’s inception until the present. The SSB has also provided such advice to other executive branch agencies, including the National Oceanic and Atmospheric Administration (NOAA), the National Science Foundation (NSF), the U.S. Geological Survey (USGS), the Department of Defense, as well as to Congress.

Space Studies Board Annual Report 2012 covers a message from the chair of the SSB, Charles F. Kennel. This report also explains the origins of the Space Science Board, how the Space Studies Board functions today, the SSB’s collaboration with other National Research Council units, assures the quality of the SSB reports, acknowledges the audience and sponsors, and expresses the necessity to enhance the outreach and improve dissemination of SSB reports.

This report will be relevant to a full range of government audiences in civilian space research – including NASA, NSF, NOAA, USGS, and the Department of Energy, as well members of the SSB, policy makers, and researchers.

[Read the full report]

Topics: Space and Aeronautics

Final Book Now Available

Chronic multisymptom illness (CMI) is a serious condition that imposes an enormous burden of suffering on our nation’s veterans. Veterans who have CMI often have physical symptoms (such as fatigue, joint and muscle pain, and gastrointestinal symptoms) and cognitive symptoms (such as memory difficulties). For the purposes of this report, the committee defined CMI as the presence of a spectrum of chronic symptoms experienced for 6 months or longer in at least two of six categories—fatigue, mood, and cognition, musculoskeletal, gastrointestinal, respiratory, and neurologic—that may overlap with but are not fully captured by known syndromes (such as CFS, fibromyalgia, and IBS) or other diagnoses. Despite considerable efforts by researchers in the United States and elsewhere, there is no consensus among physicians, researchers, and others as to the cause of CMI. There is a growing belief that no specific causal factor or agent will be identified. Many thousands of Gulf War veterans1 who have CMI live with sometimes debilitating symptoms and seek an effective way to manage their symptoms. Estimates of the numbers of 1991 Gulf War veterans who have CMI range from 175,000 to 250,000 (about 25-35% of the 1991 Gulf War veteran population), and there is evidence that CMI in 1991 Gulf War veterans may not resolve over time. Preliminary data suggest that CMI is occurring in veterans of the Iraq and Afghanistan wars as well.

In addition to summarizing the available scientific and medical literature regarding the best treatments for chronic multisymptom illness among Gulf War veterans, Gulf War and Health: Volume 9: Treatment for Chronic Multisymptom Illness recommends how best to disseminate this information throughout the VA to improve the care and benefits provided to veterans, recommends additional scientific studies and research initiatives to resolve areas of continuing scientific uncertainty and recommends such legislative or administrative action as the IOM deems appropriate in light of the results of its review.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

Over the past several decades, new scientific tools and approaches for detecting microbial species have dramatically enhanced our appreciation of the diversity and abundance of the microbiota and its dynamic interactions with the environments within which these microorganisms reside. The first bacterial genome was sequenced in 1995 and took more than 13 months of work to complete. Today, a microorganism’s entire genome can be sequenced in a few days. Much as our view of the cosmos was forever altered in the 17th century with the invention of the telescope, these genomic technologies, and the observations derived from them, have fundamentally transformed our appreciation of the microbial world around us.

On June 12 and 13, 2012, the Institute of Medicine’s (IOM’s) Forum on Microbial Threats convened a public workshop in Washington, DC, to discuss the scientific tools and approaches being used for detecting and characterizing microbial species, and the roles of microbial genomics and metagenomics to better understand the culturable and unculturable microbial world around us. Through invited presentations and discussions, participants examined the use of microbial genomics to explore the diversity, evolution, and adaptation of microorganisms in a wide variety of environments; the molecular mechanisms of disease emergence and epidemiology; and the ways that genomic technologies are being applied to disease outbreak trace back and microbial surveillance. Points that were emphasized by many participants included the need to develop robust standardized sampling protocols, the importance of having the appropriate metadata, data analysis and data management challenges, and information sharing in real time. The Science and Applications of Microbial Genomics summarizes this workshop.

[Read the full report]

Topics: Biology and Life Sciences

Prepublication Now Available

Pharmaceutical companies, academic researchers, and government agencies such as the Food and Drug Administration and the National Institutes of Health all possess large quantities of clinical research data. If these data were shared more widely within and across sectors, the resulting research advances derived from data pooling and analysis could improve public health, enhance patient safety, and spur drug development. Data sharing can also increase public trust in clinical trials and conclusions derived from them by lending transparency to the clinical research process. Much of this information, however, is never shared. Retention of clinical research data by investigators and within organizations may represent lost opportunities in biomedical research. Despite the potential benefits that could be accrued from pooling and analysis of shared data, barriers to data sharing faced by researchers in industry include concerns about data mining, erroneous secondary analyses of data, and unwarranted litigation, as well as a desire to protect confidential commercial information. Academic partners face significant cultural barriers to sharing data and participating in longer term collaborative efforts that stem from a desire to protect intellectual autonomy and a career advancement system built on priority of publication and citation requirements. Some barriers, like the need to protect patient privacy, pre- sent challenges for both sectors. Looking ahead, there are also a number of technical challenges to be faced in analyzing potentially large and heterogeneous datasets.

This public workshop focused on strategies to facilitate sharing of clinical research data in order to advance scientific knowledge and public health. While the workshop focused on sharing of data from preplanned interventional studies of human subjects, models and projects involving sharing of other clinical data types were considered to the extent that they provided lessons learned and best practices. The workshop objectives were to examine the benefits of sharing of clinical research data from all sectors and among these sectors, including, for example: benefits to the research and development enterprise and benefits to the analysis of safety and efficacy. Sharing Clinical Research Data: Workshop Summary identifies barriers and challenges to sharing clinical research data, explores strategies to address these barriers and challenges, including identifying priority actions and “low-hanging fruit” opportunities, and discusses strategies for using these potentially large datasets to facilitate scientific and public health advances.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

In October 2011, the Institute of Medicine (IOM) released the report Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence, assessing the published evidence for the effectiveness of using cognitive rehabilitation therapy (CRT) to treat people with traumatic brain injury (TBI). TBI has gained increasing attention in the past 15 years because of its status as the signature wound of American military conflicts in Iraq and Afghanistan. Growing numbers of U.S. service members are suffering traumatic brain injuries and are surviving them, given that (a) the majority of traumatic brain injuries are mild and (b) lifesaving measures for more severe injuries have significantly improved. People with any level of injury can require ongoing health care in their recovery, helping them to regain (or compensate for) their losses of function and supporting their full integration into their social structure and an improved quality of life.

One form of treatment for TBI is CRT, a systematic, goal-oriented approach to helping patients overcome cognitive impairments. The Department of Defense (DoD) asked the IOM to evaluate CRT for traumatic brain injury in order to guide the DoD’s use and coverage in the Military Health System. Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence was the IOM’s resulting study of the evidence. The report’s conclusions revolved around the fact that there is little continuity among research studies of the effectiveness of different types of CRT, and there exist only small amounts of evidence (or, in many cases, none) demonstrating the effectiveness of using CRT to treat TBI—although the evidence that does exist generally indicates that CRT interventions have some effectiveness.

The workshop brought together experts in health services administration, research, and clinical practice from the civilian and military arenas in order to discuss the barriers for evaluating the effectiveness of CRT care and for identifying suggested taxonomy, terminology, timing, and ways forward for CRT researchers. The workshop consisted of individuals and was not intended to constitute a comprehensive group. Select decision makers in the Military Health System and Veterans Affairs (VA) and researchers were invited to participate. The workshop was designed to spur thinking about (1) the types of research necessary to move the field forward toward evidence-based clinical guidelines, (2) what the translational pipeline looks like and what its current deficiencies are, and (3) considerations that decision makers may choose to use as they decide what research they will support and decide how they will balance the urgency of the need with the level of evidence for CRT interventions. Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Model Study Protocols and Frameworks to Advance the State of the Science summarizes the happenings of the workshop.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

We live in a changing world with multiple and evolving threats to national security, including terrorism, asymmetrical warfare (conflicts between agents with different military powers or tactics), and social unrest. Visually depicting and assessing these threats using imagery and other geographically-referenced information is the mission of the National Geospatial-Intelligence Agency (NGA). As the nature of the threat evolves, so do the tools, knowledge, and skills needed to respond. The challenge for NGA is to maintain a workforce that can deal with evolving threats to national security, ongoing scientific and technological advances, and changing skills and expectations of workers.

Future U.S. Workforce for Geospatial Intelligence assesses the supply of expertise in 10 geospatial intelligence (GEOINT) fields, including 5 traditional areas (geodesy and geophysics, photogrammetry, remote sensing, cartographic science, and geographic information systems and geospatial analysis) and 5 emerging areas that could improve geospatial intelligence (GEOINT fusion, crowdsourcing, human geography, visual analytics, and forecasting). The report also identifies gaps in expertise relative to NGA’s needs and suggests ways to ensure an adequate supply of geospatial intelligence expertise over the next 20 years.

[Read the full report]

Topics: Conflict and Security Issues | Earth Sciences

Final Book Now Available

Beginning with the development of the atomic bomb during World War II, the United States continued to build nuclear weapons throughout the Cold War. Thousands of people mined and milled uranium, conducted research on nuclear warfare, or worked in nuclear munitions factories around the country from the 1940s through the 1980s. Such work continues today, albeit to a smaller extent. The Department of Energy (DOE) is now responsible for overseeing those sites and facilities, many of which were, and continue to be, run by government contractors. The materials used at those sites were varied and ranged from the benign to the toxic and highly radioactive. Workers at DOE facilities often did not know the identity of the materials with which they worked and often were unaware of health risks related to their use. In many instances, the work was considered top secret, and employees were cautioned not to reveal any work-related information to family or others. Workers could be exposed to both radioactive and nonradioactive toxic substances for weeks or even years. Consequently, some of the workers have developed health problems and continue to have concerns about potential health effects of their exposures to occupational hazards during their employment in the nuclear weapons industry.

In response to the concerns expressed by workers and their representatives, DOL asked the Institute of Medicine (IOM) to review the SEM database and its use of a particular database, Haz-Map, as the source of its toxic substance-occupational disease links. Accordingly, this IOM consensus report reflects careful consideration of its charge by the committee, and describes the strengths and shortcomings of both. To complete its task, IOM formed an ad hoc committee of experts in occupational medicine, toxicology, epidemiology, industrial hygiene, public health, and biostatistics to conduct an 18-month study to review the scientific rigor of the SEM database. The committee held two public meetings at which it heard from DOL Division of Energy Employee Occupational Illness Compensation (DEEOIC) representatives, the DOL contractor that developed the SEM database, the developer of the Haz-Map database, DOE worker advocacy groups, and several individual workers. The committee also submitted written questions to DOL to seek clarification of specific issues and received written responses from DEEOIC. The committee’s report considers both the strengths and weaknesses of the SEM and the Haz-Map databases, recognizing that the latter was developed first and for a different purpose. The committee then discusses its findings and recommends improvements that could be made in both databases with a focus on enhancing the usability of SEM for both DOL claims examiners and for former DOE workers and their representatives. Review of the Department of Labor’s Site Exposure Matrix Database summarizes the committee’s findings.

[Read the full report]

Topics: Health and Medicine

Final Book Now Available

The standard incandescent light bulb, which still works mainly as Thomas Edison invented it, converts more than 90% of the consumed electricity into heat. Given the availability of newer lighting technologies that convert a greater percentage of electricity into useful light, there is potential to decrease the amount of energy used for lighting in both commercial and residential applications. Although technologies such as compact fluorescent lamps (CFLs) have emerged in the past few decades and will help achieve the goal of increased energy efficiency, solid-state lighting (SSL) stands to play a large role in dramatically decreasing U.S. energy consumption for lighting. This report summarizes the current status of SSL technologies and products—light-emitting diodes (LEDs) and organic LEDs (OLEDs)—and evaluates barriers to their improved cost and performance.

Assessment of Advanced Solid State Lighting also discusses factors involved in achieving widespread deployment and consumer acceptance of SSL products. These factors include the perceived quality of light emitted by SSL devices, ease of use and the useful lifetime of these devices, issues of initial high cost, and possible benefits of reduced energy consumption.

[Read the full report]

Topics: Energy and Energy Conservation | Engineering and Technology

Final Book Now Available

As of December 2012, Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq have resulted in the deployment of about 2.2 million troops; there have been 2,222 US fatalities in OEF and Operation New Dawn (OND)1 and 4,422 in OIF. The numbers of wounded US troops exceed 16,000 in Afghanistan and 32,000 in Iraq. In addition to deaths and morbidity, the operations have unforeseen consequences that are yet to be fully understood.

In contrast with previous conflicts, the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments. Numerous reports in the popular press have made the public aware of issues that have pointed to the difficulty of military personnel in readjusting after returning from Iraq and Afghanistan. Many of those who have served in OEF and OIF readjust with few difficulties, but others have problems in readjusting to home, reconnecting with family members, finding employment, and returning to school.

In response to the return of large numbers of veterans from Iraq and Afghanistan with physical-health and mental-health problems and to the growing readjustment needs of active duty service members, veterans, and their family members, Congress included Section 1661 of the National Defense Authorization Act for fiscal year 2008. That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical-health, mental-health, and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF, their families, and their communities as a result of such deployment.

The study consisted of two phases. The Phase 1 task was to conduct a preliminary assessment. The Phase 2 task was to provide a comprehensive assessment of the physical, psychologic, social, and economic effects of deployment on and identification of gaps in care for members and former members, their families, and their communities. The Phase 1 report was completed in March 2010 and delivered to the Department of Defense (DOD), the Department of Veterans Affairs (VA), and the relevant committees of the House of Representatives and the Senate. The secretaries of DOD and VA responded to the Phase 1 report in September 2010. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2.

[Read the full report]

Topics: Health and Medicine